ISLAMABAD, Pakistan — Amid devastating bombings directed at civilian targets in Pakistan and Afghanistan, Secretary of State Hillary Clinton began a drive Wednesday to advance Washington's policies in the troubled region by seeking to "turn the page" and convince skeptical Pakistanis that the U.S. aim is security and stability.

In Peshawar, in northwest Pakistan, Islamist insurgents detonated a car bomb in a narrow, bustling bazaar in the heart of the city hours after Clinton arrived, killing more than 100 people and wounding more than 200. The deadliest terrorist strike in Pakistan in two years attack transformed a market frequented by women seeking cosmetics into an apocalyptic scene of rubble, fire and blood.

Pakistan is reeling from a barrage of terrorist attacks that appear to be a response to the army's offensive in South Waziristan, a region on the Afghan border that's the base for Pakistani extremist groups, Afghan insurgents and al Qaida. Bombings and gun attacks have struck cities across the country since early this month, killing nearly 300 people.

In Kabul, the Afghan capital, gunmen attacked an international guesthouse early Wednesday where many U.N. employees were staying, killing at least five people, some of whom were in the country to monitor the runoff of a fraud-marred election.

The Obama administration has said that stability in Afghanistan and Pakistan is a key to U.S. homeland security, but rising casualties among American and NATO forces in Afghanistan and the uncertain outcome of national elections there have raised questions in Congress -- and throughout South Asia -- about U.S. plans for the region.

Far from considering the U.S. an ally against extremism, many Pakistanis blame the American presence in the region and Islamabad's alliance with Washington for the violence. The ready weapons, explosives and financing of the extremists who are attacking Pakistan have even led many in the country -- including parliamentarians and members of the armed forces -- to think that the violence is being orchestrated by other countries, including the United States, showing the gulf of distrust that the Obama administration must bridge.

"The main architect of these terrorist activities is the CIA," charged Riaz Pirzada, a member of parliament from the opposition Pakistan Muslim League-Q, the third-largest political party in the legislature. "America has to leave this region and let the people live their own lives."

Some expert analysts have asked why the United States is building up its forces in Afghanistan when the threat to that country and abroad emanates from groups based in Pakistan. Al Qaida is considered to be headquartered in Pakistan, with its leaders, including Osama bin Laden, hiding in the country.

Clinton, opening a high-profile three-day visit to Pakistan under intense security precautions, denounced Wednesday's bombings as she appealed for understanding of U.S. efforts to assist the region.

"They (the extremists) know they're on the losing side of history, but they are determined to take as many lives with them (as possible), as their movement is exposed for the nihilistic, empty effort that it is," she told a news conference Wednesday in Islamabad.

"The United States seeks to turn the page to a new partnership with not only the government but the people of Pakistan," she said. "We commit to stand shoulder to shoulder with the Pakistani people in your fight for peace and security."

The American image has taken a severe battering in recent weeks over an aid bill that Congress approved in September, which imposed conditions on Pakistan that some Pakistanis claimed implied that their country was a state sponsor of terrorism. This has fed a wave of anti-Americanism sweeping the country. The powerful Pakistani army publicly voiced "serious concern" about the bill, which strongly backed civilian control over the military.

Clinton said that the Pakistani debate over the bill had opened her eyes to the "misperceptions" between the countries.

She told Pakistani television anchors in an interview Wednesday that she'd come to "clear the air," but in a show of frustration over the highly charged tone of the criticism of the $1.5 billion-a-year aid bill, she added: "You don't have to take the money."

"The Pakistani people have the impression that we are being held hostage for a very meager amount," said Enver Baig, a former head of the Foreign Relations Committee in the Senate, the upper house of Pakistan's parliament. "The U.S. has to be very clear whether they are friends with open arms or not."

In Peshawar, police said that more than 330 pounds of high explosives packed into a car had caused the powerful blast. Rows of shops were flattened and a fire engulfed the area.

"It was a deafening sound, and there were plumes of smoke and dust all around the narrow and already dark streets. I could not see anything for some time and there was a smell of explosives everywhere," said Noor Khan, who'd been shopping in an adjacent market in Peshawar.

Some shop owners said that they'd previously received threats from Islamic extremists who objected to women out shopping -- in a bazaar that catered primarily to them.

"The terrorists are trying to demoralize the people and the government," said senior provincial Minister Bashir Bilour, who visited the scene. "Even if we have to die, well keep fighting these terrorists till our last breath."

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